呼吸机相关肺炎发生原因及对策  

The causes and strategies for ventilator-associated pneumonia

作　　者：乌日娜[1] 杨敬平[1] 

机构地区：[1]内蒙古医学院第三附属医院呼吸与危重症科,014010

出　　处：《临床肺科杂志》2009年第4期433-434,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨机械通气时呼吸机相关性肺炎(VAP)发生原因和防治对策。方法观察住MICU机械通气>48h的患者85例。呼吸机相关性肺炎诊断:通过观察体温、气管内吸出脓性分泌物、外周血白细胞、痰细菌培养、X线胸片。结果机械通气>48h的85例患者中,40例发生呼吸机相关性肺炎,发生率为47%;其中单纯致病菌16例,两种及两种以上致病菌24例。病原菌培养结果:铜绿假单胞菌16例、金黄色葡萄球菌12例、克雷伯杆菌16例、白色念珠菌12例、大肠埃希10例。结论铜绿假单胞菌、金黄色葡萄球菌、克雷伯杆菌、白色念珠菌是呼吸机相关性肺炎主要致病菌;缩短机械通气时间是防治肺炎的重要措施。Objective To explore the causes and prevention treatment strategies of ventilator-associated pneumonia （VAP） during mechanical ventilation. Methods Observations of 85 cases were made who received mechanical vetilation more than 48 hours in MICU. The diagnosis of pneumonia was conducted： through observing temperature, aspirating secretions nongxing from trachea, WBC, sputum culture, and X-rays. Results 40 cases were diagnosed as VAP among 85 cases who received mechanical ventilation more than 48 hours. The incidence rate of VAP was 47%. Among them, 16 eases were simple pathogen, 24 eases had two or more pathogens. The results of pathogen culture were as follows： 16 eases had pseudomonas aeruginosa, 12 eases had staphylococcus aureus, 16 eases had klebsiella pneumonia, 12 cases had candida albicans, 10 cases had eseheriehia eoli. Conclusion Pseudomonas aeruginasa, staphylococcus aureus, klebsiella pneumonia and candida albieans, are the major bacterium of VAP. Taking active prevention treatment strategies is the important measure, which will shorten the mechanical ventilation time and increase the survival rate.

关 键 词：呼吸机肺炎 医院感染 患者 防治措施 

分 类 号：R563.1[医药卫生—呼吸系统]